title: One-week postoperative patency of lower extremity in situ bypass graft comparing epidural and general anesthesia: retrospective study of 822 patients.
abstract: BACKGROUND
  The purpose of this study was to determine whether anesthesia affects graft patency after lower extremity arterial in situ bypass surgery.
  
  
  METHODS
  This investigation was a retrospective study using a national database on vascular surgical patients at a single medical institution. We assessed a total of 822 patients exposed to infrainguinal in situ bypass vascular surgery over the period of January 2000 to September 2010.
  
  
  RESULTS
  All patients included in the study (age [mean ± SD] 70.8 ± 9.7 years) underwent infrainguinal in situ bypass (n = 885) for lower extremity revascularization under epidural (n = 386) or general (n = 499) anesthesia. Thirty-day mortality (3.4% for epidural anesthesia versus 4.4% general anesthesia; P = 0.414) and comorbidity were comparable in the 2 groups. Graft occlusion within 7 days after surgery was reported in 93 patients, with a similar incidence in the epidural (10.1%) and general (10.8%) anesthesia groups (P = 0.730). When examining a subgroup of patients (n = 242) exposed to surgery on smaller vessels (femorodistal in situ bypass procedures, n = 253), the incidence of graft occlusion was also similar in the 2 groups at 14.0% and 9.4%, respectively (P = 0.262).
  
  
  CONCLUSIONS
  This retrospective study has shown that when graft patency is evaluated 7 days after surgery, anesthetic choice (epidural or general anesthesia) does not influence outcome.
authors.affiliation: Department of Anesthesia, Gentofte Hospital, Hellerup, Denmark. Electronic address: juliewiis@hotmail.com.
authors.forename: Julie Therese
authors.initials: JT
authors.lastname: Wiis
authors.affiliation: Department of Anesthesia, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Jensen-Gadegaard
authors.affiliation: Department of Vascular Surgery, Rigshospitalet, København, Denmark.
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Altintas
authors.affiliation: Department of Vascular Surgery, Gentofte Hospital, Hellerup, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Seidelin
authors.affiliation: Department of Anesthesia 2041, Rigshospitalet, København, Denmark.
authors.forename: Robertas
authors.initials: R
authors.lastname: Martusevicius
authors.affiliation: Department of Anesthesia 2041, Rigshospitalet, København, Denmark.
authors.forename: Teit
authors.initials: T
authors.lastname: Mantoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000401:mortality; D000768:Anesthesia, General / Q000009:adverse effects / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality